The present invention relates to novel pharmaceutically active disubstituted heterocyclic compounds with high affinity for central dopaminergic receptors. The compounds of the present invention are antagonists of the dopamine D4 receptor and are useful in the treatment of central nervous system disorders, especially psychotic disorders such as schizophrenia.
Molecular biological techniques have revealed the existence of several subtypes of the dopamine receptor. The dopamine D1 receptor subtype has been shown to occur in at least two discrete forms. Two forms of the D2 receptor subtype, and at least one form of the D3 receptor subtype, have also been discovered. More recently, the D4 (Van Tol et al., Nature (London), 1991, 350, 610) and D5 (Sunahara et al., Nature (London), 1991, 350, 614) receptor subtypes have been described.
The xe2x80x9cdopamine hypothesisxe2x80x9d of schizophrenia predicts an increased activity of dopamine neurotransmission in the brain. This hypothesis is supported by observations that drugs, such as amphetamine and cocaine, which indirectly stimulate the endogenous dopamine system by a dopamine release and reuptake inhibition are capable of eliciting a psychosis resembling acute paranoid schizophrenia. The fact that classical antipsychotic drugs produce their therapeutic effect by blocking central dopamine D2 receptors also lends credence to the xe2x80x9cdopamine hypothesisxe2x80x9d. It is however a serious drawback to the classical anti-psychotic drugs that the blockade of dopamine D2 receptors also leads to extrapyrimidal side effects (EPS).
Clozapine is the only neuroleptic agent that improves the xe2x80x9cpositivexe2x80x9d and xe2x80x9cnegativexe2x80x9d symptoms of schizophrenia without producing EPS. The mechanism of action of Clozapine remains elusive, but has been proposed to be due, in part to a greater blockade of dopamine D4 receptors compared to D2 receptors, and also to a blockade of serotonin 5-HT2A receptors. It is considered that compounds which can interact selectively with the dopamine D4 receptor subtype, whilst having a less pronounced action at the D2 subtype will be less prone to give the side-effects associated with classical antipsychotic drugs while maintaining a beneficial level of antipsychotic activity.
The compounds of the present invention possess a high and selective affinity for dopamine D4 receptors relative to the dopamine D2 receptors.
As the compounds of the present invention are antagonists of the dopamine D4 receptor they are predicted to be useful for the treatment of psychotic disorders such as schizophrenia.
Dopamine receptors are important for many functions in the animal body, For example, altered functions of these receptors participate in the genesis of psychosis, addiction. sleep, feeding, learning, memory, sexual behaviour, regulation of immunological responses and blood pressure. Since dopamine receptors control a great number of pharmacological events, compounds that act preferentially on the dopamine D4 receptor may exert a wide range of therapeutic effects in humans. The compounds of the present invention may therefore also be useful for the treatment of conditions such as sleep disorders, sexual disorders, gastrointestinal disorders, various form of psychosis (affective psychosis, nonorganic psychosis), personality disorders, psychiatric mood disorders, conduct and impulse disorders, schizophrenic and schizoaffective disorders, conduct and impulse disorders, polydipsia, bipolar disorders, dysphoric mania, anxiety and related disorders, obesity, emesis, learning disorders, memory disorders, Parkinson""s disease, depression, neuroteptic malignant syndrome, hypothalamic pituitary disorders, congestive heart failure, chemical dependencies such as drug and alcohol addictions, vascular and cardiovascular disorders, ocular disorders (including glaucoma), dystonia, tardive dyskinesia, Gilles De La Tourette""s syndrome and other hyperkinesias, dementia, ischaemia, movement disorders such as akathesia, hypertension and diseases caused by a hyperactive immune system such as allergies and inflammation.
U.S. Pat. No. 4,088,814 describes certain morpholine derivatives having the formula 
wherein A means ethylene or vinylene and X means optionally substituted phenyl. The compounds are claimed to have psychotropic activity, e.g. antidepressant and sedative activity. Some compounds also show analgesic activity. Compounds described herein having a benzyl group attached in position 4 are used as intermediates for the preparation of the therapeutically active compounds.
GB patent No. 1.138.405 describes certain morpholine derivatives having the formula 
wherein R1 and R2 means hydrogen or alkyl, R3 means hydrogen, alkyl, alkenyl, or cycloalkyl, and X means an optionally substituted aryl radical. The compounds described herein possess depressant action on the central nervous system, and are said to be useful in the treatment of anxiety, neurotic states and epilepsy. Some of the compounds are said to possess anti-depressant activity. The compounds described herein having a arylalkyl group attached in position 4 are used as intermediates for the preparation of the therapeutically active compounds.
A well known compound disclosed in the above patent is Viloxazine or 2-[(2-ethoxy-phenoxy)methyl]morpholine. This compound have no or only low affinity for the central dopaminergic D2 and D4 receptors.
GB patent No.1.310.236 describes certain morpholine derivatives which are useful as intermediates for the preparation of therapeutically active compounds.
It is an object of the present invention to provide novel disubstituted heterocyclic compounds and pharmaceutically-acceptable acid addition salts thereof which are useful for the treatment of central nervous system disorders, or diseases responsive to the blockade of dopamine D4 receptors, especially psychotic disorders such as schizophrenia.
Another object of the present invention is to provide pharmaceutical compositions comprising the novel disubstituted heterocyclic compounds being useful for above purposes.
Still another object of the present invention is to provide a method of treating disorders or diseases responsive to the blockade of dopamine D4 receptors using the novel disubstituted heterocyclic compounds.
Additional objects will be obvious from the following description, and others will be obvious to one skilled in the art.
The invention then, inter alia, comprises the following, alone or in combination:
A compound of the formula 
any of its enantiomers, or any mixture thereof, or a pharmaceutically acceptable acid addition salt thereof,
wherein
R1, R2, R3, R4, R11, R12, R13, R14, and R15 each independently are hydrogen, alkyi, alkoxy, halogen, trifluoromethyl, nitro, cyano, amino, acyl, aminocarbonyl, or acylamino;
R5 is hydrogen, alkyl, alkoxyalkyl, or phenylalkyl;
X is xe2x80x94CH2xe2x80x94Zxe2x80x94, xe2x80x94Zxe2x80x94CH2xe2x80x94, xe2x80x94NHxe2x80x94COxe2x80x94, xe2x80x94COxe2x80x94NHxe2x80x94, or xe2x80x94CHxe2x95x90CHxe2x80x94; wherein Z is O, S, CH2 or NH;
Y is O, xe2x80x94CH2xe2x80x94Wxe2x80x94, xe2x80x94Wxe2x80x94CH2xe2x80x94; wherein W is O, or S;
and n is 0, 1, or 2;
a compound as above which is (xc2x1)-N-(4-chlorobenzyl)-2-(2-methoxy-4-chloro-phenoxymethyl)-morpholine, or (xc2x1)-2-[(4-chloro-2-methoxyphenoxy)methyl]-4-(4-chlorobenzyl)perhydro oxazepine or a pharmaceutically acceptable acid addition salt thereof;
a pharmaceutical composition, comprising an effective amount of a compound as any above, or a pharmaceutically acceptable acid addition salt thereof, together with at least one pharmaceutically acceptable carrier or diluent:
the use of a compound having the formula 
xe2x80x83any of its enantiomers, or any mixture thereof, or a pharmaceutically acceptable acid addition salt thereof,
wherein
R1, R2, R3, R4, R11, R12, R13, R14, and R15 each independently are hydrogen, alkyl, alkoxy, halogen, trifluoromethyl, nitro, cyano, amino, acyl, aminocarbonyl, or acylamino;
R5 is hydrogen, alkyl, alkoxyalkyl, or phenytalkyl;
X is xe2x80x94CH2xe2x80x94Zxe2x80x94, xe2x80x94Zxe2x80x94CH2xe2x80x94, xe2x80x94NHxe2x80x94COxe2x80x94, xe2x80x94COxe2x80x94NHxe2x80x94, or xe2x80x94CH=CHxe2x80x94; wherein Z is O, S, CH2 or NH;
Y is O, xe2x80x94CH2xe2x80x94Wxe2x80x94, xe2x80x94Wxe2x80x94CH2xe2x80x94; wherein W is O, or S;
and n is 0, 1, or 2 for the manufacture of a medicament for the treatment of a disorder or disease of a living animal body, including a human, which disorder or disease is responsive to the blockade of dopamine D4 receptors of the central nervous system;
the use of a compound as above for the manufacture of a medicament for the treatment of psychotic disorders including schizophrenia;
the use as above, wherein the compound employed is N-(4-chlorobenzyl)-2-(2-methoxy-4-chloro-phenoxymethyl)-morpholine, or (xc2x1)-2-[(4-chloro-2-methoxyphenoxy)methyl]-4-(4-chlorobenzyl)perhydro oxazepineor a pharmaceutically acceptable acid addition salt thereof;
a method for the treatment of a disorder or disease which is responsive to the blockade of dopamine D4 receptors of the central nervous system comprising administering to a living animal body, including a human, in need thereof a therapeutically effective amount of a compound of the formula 
xe2x80x83any of its enantiomers, or any mixture thereof, or a pharmaceutically acceptable acid addition salt thereof,
wherein
R1, R2, R3, R4, R11, R12, R13, R14, and R15 each independency are hydrogen, alkyl, alkoxy, halogen, trifluoromethyl, nitro, cyano, amino, acyl, aminocarbonyl, or acylamino;
R5 is hydrogen, alkyl, alkoxyalkyl, or phenylalkyl;
X is xe2x80x94CH2xe2x80x94Zxe2x80x94, xe2x80x94Zxe2x80x94CH2xe2x80x94, xe2x80x94NHxe2x80x94COxe2x80x94, xe2x80x94COxe2x80x94NHxe2x80x94, or xe2x80x94CH=CHxe2x80x94; wherein Z is O, S, CH2 or NH;
Y is O, xe2x80x94CH2xe2x80x94Wxe2x80x94, xe2x80x94Wxe2x80x94CH2xe2x80x94; wherein W is O,or S;
and n is 0,1, or 2;
a method as above wherein the disorder or disease is a psychotic disorder, including schizophrenia; and
a method for the preparation of a compound as above comprising the step of reacting
a) reacting a compound having the formula 
xe2x80x83wherein R1, R2, R3, R4, R5, and X is as defined in claim 1, with a compound having the formula 
xe2x80x83wherein R11, R12, R13, R14 and R15 is as defined in claim 1 and Hal is halogen, to form a compound of the invention; or
b) reacting a compound having the formula 
xe2x80x83wherein R11, R12, R13, R14 and R15 is as defined in claim 1 and Hal is halogen, with a compound having the formula 
xe2x80x83wherein R1, R2, R3, R4 and R5 is as defined in claim 1, to form a compound of the invention, whereafter a compound of the invention is optionally converted to another compound of the invention and/or to a pharmaceutically acceptable salt of a compound of the invention.
Examples of pharmaceutically acceptable addition salts include inorganic and organic acid addition salts such as the hydrochloride, hydrobromide, phosphate, nitrate, perchlorate, sulphate, citrate, lactate, tartrate, maleate, fumarate, mandelate, benzoate, ascorbate, cinnamate, benzenesulfonate, methanesulfonate, stearate, succinate, glutamate, glycollate, toluene-p-sulphonate, formate, malonate, naphthalene-2-sulphonate, salicylate and the acetate. Such salts are formed by procedures well known in the art.
Other acids such as oxalic acid, while not in themselves pharmaceutically acceptable, may be useful in the preparation of salts useful as intermediates in obtaining compounds of the invention and their pharmaceutically acceptable acid addition salts.
Halogen is fluorine, chlorine, bromine or iodine.
Alkyl means a straight chain or branched chain of preferably one to six carbon atoms or cyclic alkyl of preferably three to seven carbon atoms, including but not limited to, methyl, ethyl, propyl, isopropyl, butyl, isobutyl, t-butyl, pentyl, hexyl, cyclopropyl, cyclobutyl, cyciopentyl, cyclohexyl; methyl, ethyl, propyl and isopropyl are particularly preferred groups.
Acyl means xe2x80x94CO-alkyl wherein alkyl is as defined above.
Acylamino means Acyl-NHxe2x80x94 wherein acyl is as defined above.
Amino is NH2 or NH-alkyl or N-(alkyl)2, wherein alkyl is as defined above.
The compounds of the invention are preferably oxazepines.
I.p. means intraperetoneally, which is a well known route of administration.
P.o. means peroral, which is a well known route of administration.
The compounds of the invention may be prepared in numerous ways. The compounds of the invention and their pharmaceutically acceptable derivatives may thus be prepared by any method known in the art for the preparation of compounds of analogous structure, and as shown in the representative example which follow.
Starting materials for the processes described in the present patent application are known or can be prepared by known processes from commercially available materials.
A compound of the invention can be converted to another compound of the invention using conventional methods.
The products of the reactions described herein are isolated by conventional means such as extraction, crystallizabon, distillation, chromatography, and the like.
Further, the compounds of this invention may exist in unsolvated as well as in solvated forms with pharmaceutically acceptable solvents such as water, ethanol the like. In general, the solvated forms are considered equivalent to the unsolvated forms for the purposes of this invention.
It will be appreciated by those skilled in the art that the compounds of the present invention contain chiral centres and that such compounds exist in the form of isomers (i.e. enantiomers). The invention includes all such isomers and any mixtures thereof including racemic mixtures.
A prefered embodiment of the invention comprises the compounds of claim 1 wherein Y is xe2x80x94Oxe2x80x94 or xe2x80x94CH2xe2x80x94Oxe2x80x94 and X is xe2x80x94CH2xe2x80x94 with S configuration.
The pure enantiomers can be obtained by the use of optically active starting materials.
Racemic forms can also be resolved into the optical antipodes by known methods, for example, by separation of diastereomeric salts thereof with an optically active acid, and liberating the optically active amine compound by treatment with a base. Another method for resolving racemates into the optical antipodes is based upon chromatography on an optically active matrix. Racemic compounds of the present invention can thus be resolved into their optical antipodes, e.g., by fractional crystallization of d- or I-(tartrates, mandelates, or camphorsulphonate) salts for example. The compounds of the present invention may also be resolved by the formation of diastereomeric amides by reaction of the compounds of the present invention with an optically active activated carboxylic acid such as that derived from (+) or (xe2x88x92) phenylalanine, (+) or (xe2x88x92) phenylglycine, (+) or (xe2x88x92) camphanic acid or by the formation of diastereomeric carbamates by reaction of the compounds of the present invention with an optically active chloroformate or the like.
Additional methods for the resolvation of optical isomers, known to those skilled in the art may be used, and will be apparent to the average worker skilled in the art. Such methods include those discussed by J. Jaques, A. Collet, and S. Wilen in xe2x80x9cEnantiomers, Racemates, and Resolutionsxe2x80x9d, John Wiley and Sons, New York (1981).
The compounds of the present invention exhibit a high affinity for dopamine D4 receptors and a much lower affinity for dopamine D2 receptors. The affinity of certain compounds of the invention for the dopamine D2 receptor and the dopamine D4 receptor have been determined by measuring the ability of the compounds to inhibit the binding of 3H-spiperone to these receptors using the procedure described below:
Dopamine is involved in several important functions, excitatory and inhibitory, via dopaminergic receptors in the central nervous system (CNS) and in the periphery. Dopaminergic systems are of particular interest because of their role in the etiology and management of various CNS disorders, such as Parkinson""s disease and schizophrenia.
Dopamine receptors were originally classified into two main groups: D1 and D2. The five currently cloned dopamine receptors fall into these classes. Thus, the D1-like receptors include D1 and D5, while the D2-like receptors include D2, D3 and D4. Dopaminergic receptors are coupled via two distinct G-proteins to intracellular signalling mechanisms. D1 and D2-like receptors are coupled respectively to stimulation and inhibition of the effector enzyme adenylyl cyclase, which produces the second messenger cAMP.
The D2-like receptors can be labelled by the antagonist 3H-spiperone. As the ligand has the same affinity for D2, D3, and D4 receptors, selective binding to i.e. D4 receptors is only possible using recombinant receptors.
Tissue preparation: Preparations are performed at 0-4xc2x0 C. unless otherwise indicated. Corpus Striatum from male Wistar rats (150-200 g) is homogenized for 5-10 sec in 10 ml KH2PO4 (50 mM, pH 7.4) using an Ultra-Turrax homogenizer. The suspension is centrifuged at 27,000xc3x97g for 15 min. The supematant is discarded and the pellet is resuspended in 50 mM KH2PO4, pH 7.4 (2000 ml per g of original tissue) and used for binding assays.
Assay: Aliquots of 0.5 ml tissue are added to 25 xcexcl of test solution and 25 xcexcl of 3H-spiperone (0.2 nM, final concentration), mixed and incubated for 20 min at 37xc2x0 C. Non-specific binding is determined using butadamol (1 xcexcM, final concentration). After incubation the samples are placed on ice for 10 min. The assay is terminated by addition of 5 ml of ice-cold buffer and poured directly onto Whatman GF/C glass fibre filters (presoaked in 0.1% PEI for at least 20 min) under suction and immediately washed with 5 ml ice-cold buffer. The amount of radioactivity on the filters is determined by conventional liquid scintillation counting. Specific binding is total binding minus non-specific binding.
Tissue preparation: Frozen membranes from Chinese Hamster Ovary (CHO) cells transfected with the human recombinant D4.2 dopamine receptor (RBI, D-195). Membranes are suspended in 10 mM Tris-HCl (pH 7.2) containing 2 mM EDTA, and stored tightly sealed at xe2x88x9280xc2x0 C.
Asssay: The membranes are thawed and diluted in incubation buffer (50 mM Tns-HCl, pH 7.4, containing 120 mM NaCl, 5 mM KCl, 5 mM MgCl2 and 1 mM EDTA) xe2x80x940.25 ml of membranes to 4.75 ml of incubation buffer. Aliquots of 100 xcexcl of diluted membranes are added to 100 xcexcl of test solution and 50 xcexcl of 3H-spiperone (0.5nM, final concentration). Finally, 750 xcexcl incubation buffer is added and the assay mixture is incubated for 60 min at 25xc2x0 C. Non-specific binding is determined using haloperidol (1 xcexcM, final concentration). After incubation the assay is terminated by rapid filtration over GF/C glass fibre filters (presoaked in 0.1% PEI for at least 20 min), then washed twice with 5 ml ice cold 50 mM Tris-HCl in 0.9% NaCl at pH 7.4. The amount of radioactivity on the filters is determined by conventional liquid scintillation counting. Specific binding is total binding minus non-specific binding.
The test values are given as IC50 (the concentration of the test substance which inhibits the specific binding of 3H-spiperone by 50%).
The results obtained by testing certain compounds of the invention are presented in table 1:
While it is possible that, for use in therapy, a compound of the invention may be administered as the raw chemical, it is preferable to present the active ingredient as a pharmaceutical formulation.
The invention thus further provides pharmaceutical formulations comprising a compound of the invention or a pharmaceutically acceptable salt or derivative thereof together with one or more pharmaceutically acceptable carriers therefor and, optionally, other therapeutic and/or prophylactic ingredients. The carrier(s) must be xe2x80x9cacceptablexe2x80x9d in the sense of being compatible with the other ingredients of the formulation and not deleterious to the recipient thereof.
Pharmaceutical formulations include those suitable for oral, rectal, nasal, topical (including buccal and sub-lingual), vaginal or parenteral (including intramuscular, sub-cutaneous and intravenous) administration or in a form suitable for administration by inhalation or insufflation.
The compounds of the invention, together with a conventional adjuvant, carrier, or diluent, may thus be placed into the form of pharmaceutical compositions and unit dosages thereof, and in such form may be employed as solids, such as tablets or filled capsules, or liquids such as solutions, suspensions, emulsions, elixirs, or capsules filled with the same, all for oral use, in the form of suppositories for rectal administration; or in the form of sterile injectable solutions for parenteral (including subcutaneous) use. Such pharmaceutical compositions and unit dosage forms thereof may comprise conventional ingredients in conventional proportions, with or without additional active compounds or principles, and such unit dosage forms may contain any suitable effective amount of the active ingredient commensurate with the intended daily dosage range to be employed. Formulations containing ten (10) milligrams of active ingredient or, more broadly, 0.1 to one hundred (100) milligrams, per tablet, are accordingly suitable representative unit dosage forms.
The compounds of the present invention can be administrated in a wide variety of oral and parenteral dosage forms. It will be obvious to those skilled in the art that the following dosage forms may comprise, as the active component, either a compound of the invention or a pharmaceutically acceptable salt of a compound of the invention.
For preparing pharmaceutical compositions from the compounds of the present invention, pharmaceutically acceptable carriers can be either solid or liquid. Solid form preparations include powders, tablets, pills, capsules, cachets, suppositories, and dispersible granules. A solid carrier can be one or more substances which may also act as diluents, flavouring agents, solubilizers, lubricants, suspending agents, binders, preservatives, tablet disintegrating agents, or an encapsulating material.
In powders, the carrier is a finely divided solid which is in a mixture with the finely divided active component.
In tablets, the active component is mixed with the carrier having the necessary binding capacity in suitable proportions and compacted in the shape and size desired.
The powders and tablets preferably contain from five or ten to about seventy percent of the active compound. Suitable carriers are magnesium carbonate, magnesium stearate, talc, sugar, lactose, pectin, dextrin, starch, gelatin, tragacanth, methylcellulose, sodium carboxymethylcellulose, a low melting wax, cocoa butter, and the like. The term xe2x80x9cpreparationxe2x80x9d is intended to include the formulation of the active compound with encapsulating material as carrier providing a capsule in which the active component, with or without carriers, is surrounded by a carrier, which is thus in association with it. Similarly, cachets and lozenges are included. Tablets, powders, capsules, pills, cachets, and lozenges can be used as solid forms suitable for oral administration.
For preparing suppositories, a low melting wax, such as admixture of fatty acid glycerides or cocoa butter, is first melted and the active component is dispersed homogeneously therein, as by stirring. The molten homogenous mixture is then poured into convenient sized molds, allowed to cool, and thereby to solidify.
Formulations suitable for vaginal administration may be presented as pessaries, tampons, creams, gels, pastes, foams or sprays containing in addition to the active ingredient such carriers as are known in the art to be appropriate.
Liquid form preparations include solutions, suspensions, and emulsions, for example, water or water-propylene glycol solutions. For example, parenteral injection liquid preparations can be formulated as solutions in aqueous polyethylene glycol solution.
The compounds according to the present invention may thus be formulated for parenteral administration (e.g. by injection, for example bolus injection or continuous infusion) and may be presented in unit dose form in ampoules, pre-filled syringes, small volume infusion or in multi-dose containers with an added preservative. The compositions may take such forms as suspensions, solutions, or emulsions in oily or aqueous vehicles, and may contain formulatory agents such as suspending, stabilising and/or dispersing agents. Altematively, the active ingredient may be in powder form, obtained by aseptic isolation of sterile solid or by lyophilisation from solution, for constitution with a suitable vehicle, e.g. sterile, pyrogen-free water, before use.
Aqueous solutions suitable for oral use can be prepared by dissolving the active component in water and adding suitable colorants, flavours, stabilizing and thickening agents, as desired.
Aqueous suspensions suitable for oral use can be made by dispersing the finely divided active component in water with viscous material, such as natural or synthetic gums, resins, methylcellulose, sodium carboxymethylcellulose, or other well known suspending agents.
Also included are solid form preparations which are intended to be converted, shortly before use, to liquid form preparations for oral administration. Such liquid forms include solutions, suspensions, and emulsions. These preparations may contain, in addition to the active component, colorants, flavours, stabilizers, buffers, artificial and natural sweeteners, dispersants, thickeners, solubilizing agents, and the like.
For topical administration to the epidermis the compounds according to the invention may be formulated as ointments, creams or lotions, or as a transdermal patch. Ointments and creams may, for example, be formulated with an aqueous or oily base with the addition of suitable thickening and or gelling agents. Lotions may be formulated with an aqueous or oily base and will in general also contain one or more emulsifying agents, stabilising agents, dispersing agents, suspending agents, thickening agents, or colouring agents.
Formulations suitable for topical administration in the mouth include lozenges comprising active agent in a flavoured base, usually sucrose and acacia or tragacanth; pastilles comprising the active ingredient in an inert base such as gelatin and glycerin or sucrose and acacia; and mouthwashes comprising the active ingredient in a suitable liquid carrier.
Solutions or suspensions are applied directly to the nasal cavity by conventional means, for example with a dropper, pipette or spray. The formulations may be provided in single or multidose form. In the latter case of a dropper or pipette, this may be achieved by the patient administering an appropriate, predetermined volume of the solution or suspension. In the case of a spray, this may be achieved for example by means of a metering atomising spray pump.
Administration to the respiratory tract may also be achieved by means of an aerosol formulation in which the active ingredient is provided in a pressurised pack with a suitable propellant such as a chlorofluorocarbon (CFC) for example dichlorodifluoromethane, trichlorofluoromethane, or dicnlorotetrafluoroethane, carbon dioxide, or other suitable gas. The aerosol may conveniently also contain a surfactant such as lecithin. The dose of drug may be controlled by provision of a metered valve.
Alternatively the active ingredients may be provided in the form of a dry powder, for example a powder mix of the compound in a suitable powder base such as lactose, starch, starch derivatives such as hydroxypropylmethyl cellulose and polyvinylpyrrolidone (PVP). Conveniently the powder carrier will form a gel in the nasal cavity. The powder composition may be presented in unit dose form for example in capsules or cartridges of, e.g., gelatin, or blister packs from which the powder may be administered by means of an inhaler.
In formulations intended for administration to the respiratory tract, including intranasal formulations, the compound will generally have a small particle size for example of the order of 5 microns or less. Such a particle size may be obtained by means known in the art, for example by micronization.
When desired, formulations adapted to give sustained release of the active ingredient may be employed.
The pharmaceutical preparations are preferably in unit dosage forms. In such form, the preparation is subdivided into unit doses containing appropriate quantities of the active component. The unit dosage form can be a packaged preparation, the package containing discrete quantities of preparation, such as packeted tablets, capsules, and powders in vials or ampoules. Also, the unit dosage form can be a capsule, tablet, cachet, or lozenge itself, or it can be the appropriate number of any of these in packaged form.
Tablets or capsules for oral administration and liquids for intravenous administration are preferred compositions.
The compounds of this invention possess potent dopamine D4 receptor blocking activity. This property make the compounds of the present invention extremely useful in the treatment of psychotic disorders such as schizophrenia as well as other disorders sensitive to the blockade of dopamine D4 receptors. The compounds of this invention may accordingly be administered to a living animal body, including a human, in need of treatment, alleviation, or elimination of an indication associated with or responsive to the blockade of dopamine receptors, especially the dopamine D4 receptor. This includes especially schizophrenia and other psychotic disorders. Suitable dosage range are 0.1-500 milligrams daily, and especially 10-70 milligrams daily, administered once or twice a day, dependent as usual upon the exact mode of administration, form in which administered, the indication toward which the administration is directed, the subject involved and the body weight of the subject involved, and further the preference and experience of the physician or veterinarian in charge.